Provider Demographics
NPI:1427255405
Name:LOBIANCO, SHELLA J (MS,PT)
Entity type:Individual
Prefix:
First Name:SHELLA
Middle Name:J
Last Name:LOBIANCO
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:SHELLA
Other - Middle Name:
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 S ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5827
Mailing Address - Country:US
Mailing Address - Phone:919-932-7266
Mailing Address - Fax:919-932-7250
Practice Address - Street 1:77 S ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5827
Practice Address - Country:US
Practice Address - Phone:919-932-7266
Practice Address - Fax:919-932-7250
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14164225100000X
FLPT 23052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAI268AMedicare UPIN